Two cases of optical coherence tomography angiography in leber hereditary optic neuropathy

Purpose: To report on the application of optical coherence tomography angiography(OCTA) for the detection of peripapillary abnormalities in 4 eyes with Leber hereditary optic neuritis(LHON). Case 1: A 23-year-old man was referred to our department with visual impairment in his left eye. A mitochondrial DNA 11778 point mutation was detected. Microscopic examination showed optic disc swelling in both eyes. Fluorescence angiography(FA) demonstrated peripapillary telangiectatic blood vessels and vascular tortuosity without corresponding leakage in both discs. OCTA demonstrated parapapillary telangiectatic blood vessels in both eyes. Case 2: A 5-year-old boy was referred to our department with visual impairment in his left eye. A mitochondrial DNA 11778 point mutation was detected. Microscopic examination showed optic disc swelling in the right eye and disc pallor in the left eye. FA demonstrated peripapillary telangiectatic blood vessels and vascular tortuosity without corresponding leakage in the right eye only and hyperfluorescence in the left disc. In contrast, OCTA demonstrated parapapillary telangiectatic blood vessels in both eyes Conclusion: OCTA is a safe and convenient imaging modality that can be used to obtain multiple scans. Further, OCTA may be a useful diagnostic tool for evaluating the eyes of patients with LHON.